Angus and Rosemary's Miscellany
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Coronavirus (COVID-19) epidemic weekly update for Malvern SeniorsCOVID LOCKDOWN in ENGLAND Alert Level raised to 5 on January 4th DAILY INFECTION RATE STILL HIGH PM says 'STAY AT HOME' Skip to menu of archived pages PreambleWe keep an eye on the published government figures to asses the level of risk in the Malvern Hills district, if there is an uptick in cases we will tell you. This page is updated every Sunday between 1800 and 2400 hours GMT. Information about Coronavirus can be found on the NHS website: https://www.nhs.uk/coronavirus
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consider helping others by downloading the COVID Symptom Study app onto your
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able. Note that currently there is no desktop PC version for Windows.
| Districts of Worcs | Cases | Weekly increase | Population |
| Bromsgrove | 5,899 | +101 | 98,529 |
| Malvern Hills | 2,537 | +104 | 77,545 |
| Redditch | 5,555 | +201 | 85,317 |
| Worcester | 5,678 | +119 | 103,542 |
| Wychavon | 5,968 | +163 | 126,240 |
| Wyre Forest | 5,017 | +130 | 100,957 |
| TOTAL | 30,654 | +818 | 592,130 |
| COMPARE WITH | |||
| County of Hereford | 6,499 | +188 | 195,000 |
| Leicester (city of) | 33,176 | +880 | 400,000 |
Cumulative cases reported by PHE in Worcestershire to 21st February 2021
Interactive map
At the bottom of the Coronavirus Dashboard (daily update) page there is an Interactive Map which is coloured to show the variation in infection rate across the country. This shows how the rate of infection has fallen across the UK since the start of the lockdown.
Click for Interactive Map of COVID cases
Note: the Interactive Map works on desktop PCs but it's possible you may encounter difficulties using a tablet or smartphone.
Recent weekly cases to 16th February are: North Malvern 17; Malvern Link 13; Pickersleigh 10; Barnards Green 7; Malvern Wells and Priory <3; Callow End and Hanley 7; Upton and Welland 5. The picture changes daily.
Number of deaths
Statistics on COVID deaths are published by Public Health England, The Office of National Statistics, and NHS England; these show the third wave daily death rate has passed its peak and begun to fall.
PHE figures
Public Health England reports that the cumulative total of COVID (28) deaths in UK hospitals and care homes has risen by 3,414 in the last week to 120,580 while the daily average has fallen from 672 to 488; see chart below which shows the actual daily death rate in red, and our forecast to the 7th March in blue.
Daily UK death rate from 27th Dec to 21st February 2021 and forecast
Click to view the UK government Coronavirus Dashboard
In comparison averaged over recent years 1,700 people die daily from all causes.
ONS figures
The Office of National Statistics (ONS) separately reports registered deaths in England and Wales where COVID-19 is mentioned on the death certificate. The ONS figures lag the PHE figures by 10 - 14 days and do not include NI and Scotland, so are lower than the figures published by PHE.
The ONS figures are broken down by District providing a glimpse where deaths are occurring. The cumulative total of COVID related deaths in Worcestershire reported by the ONS up to 5th February 2021 (week 5 of 2021) is shown below.
| Districts of Worcs | Deaths 2020 |
Deaths 2021 |
Weekly increase | Population |
| Bromsgrove | 164 | 72 | +16 | 98,529 |
| Malvern Hills | 61 | 55 | +9 | 77,545 |
| Redditch | 108 | 57 | +17 | 85,317 |
| Worcester | 87 | 86 | +12 | 103,542 |
| Wychavon | 157 | 86 | +24 | 126,240 |
| Wyre Forest | 171 | 57 | +11 | 100,957 |
| TOTAL | 748 | 413 | +89 | 592,130 |
Cumulative COVID deaths registered by ONS to 5th February 2021
In the week ending 5th February, there were 89 COVID related deaths in Worcestershire, of which 23 were in care homes, 4 at home, 1 in a hospice and 61 in hospital; a rise of 11 on last week.
In total in England and Wales 7,618 COVID related deaths were reported by the ONS in the week to 5th February, a fall of 1,167 (13%) on the week before.
The highest number of hospital deaths (>29) by Lower Tier Local Authority were:
Leicester 40, County Durham 34, Cheshire East 39, Cheshire West 44, Bedford 31,Bournemouth Christchurch and Poole 57, Buckinghamshire 53, Tendring 36, Manchester 37, Liverpool 67, St Helens 41, Wirral 30, Sheffield 36, Birmingham 108, Coventry 33, Dudley 39, Sandwell 46, Solihull 33, Walsall 36, Leeds 30, Bexley 33, Bromley 37, Croydon 50, Hillingdon 48, Hounslow 36, Lambeth 31, Betsi Cadwaladr University Health Board 50, Aneurin Bevan University Health Board 32, Cardiff and Vale University Health Board 55, Cwm Taf Morgannwg University Health Board 35.
Once again Birmingham had the highest death rate.
The cumulative total of COVID related deaths in England and Wales recorded by the ONS for all weeks of the epidemic rose to 125,145.
| Year | Cumulative COVID related deaths in England and Wales |
| 2020 | 85,686 |
| 2021 | 39,459 |
| TOTAL | 125,145 |
COVID death toll in England and Wales to 5th February 2021 (by ONS)
Click for national ONS data on deaths (Excel spreadsheet)
NHS England figures
More recently in the seven days ending 21st February NHS England reported the cumulative total of deaths in Worcestershire hospitals rose by 20 to 801.
Click for NHS COVID-19 Daily Deaths
Healthcare numbers
The UK government Coronavirus Dashboard includes important information about healthcare statistics.
| Hospital cases (UK) | Number | Weekly change |
| Patients currently in hospital | 18,462 | -4,879 |
| Patients on ventilation | 2,469 | -474 |
| Patients admitted daily | 1,397 | -318 |
Headline summary of patients in hospital as reported 21st February 2021
These headline figures show the number of COVID patients in hospital has continued to fall and is now roughly half the peak.
The number of patients on ventilators is falling slowly.
Daily admissions are down only slightly this week. The steady state number of COVID patients in hospital seems to be roughly ten time the number of patients admitted daily, suggesting a fall to 14,000 patients is on the way.
Figures for bed occupancy in Worcestershire hospitals can be found on the NHS England website and the Worcestershire Coronavirus Dashboard.
Click for NHS England COVID-19 Hospital Activity
Note: The Welsh First Minister said some time ago that very sick COVID patients arrive in hospital 7 to 10 days after first symptoms, and either die or are discharged 15 to 30 days after first symptoms in most cases. Hospital beds are occupied by suspected COVID patients, very sick COVID patients, and a few suffering from 'Long COVID' who may remain in hospital for much longer than 30 days.
Notes on projected figures for deaths
Statistician Sir David Spiegelhalter of Cambridge University speaking on BBC TV last year said that, using his rule of thumb, hospital admissions were likely to be about 10% of reported new cases, one week after symptoms; and deaths were likely to be about 2% of new cases, 2 to 3 weeks after that - which would point to about 220 hospital deaths per day by early March.
Once a large proportion of the population has been vaccinated this rule of thumb will no longer apply, and COVID deaths should fall sharply.
Forecast for the week ahead
Trends suggest that during the next seven days (up to 28th February) the cumulative total of new UK COVID-19 cases reported by PHE on the Coronavirus Dashboard could increase by about 70,000 towards 4,186,000.
In Worcestershire up to 850 new cases of COVID-19 can be expected, and possibly up to 120 cases in the Malvern Hills district.
We estimate the number of COVID (28) deaths could increase by about 2,500 nationally towards 123,000 during the 7 days ending 28th February 2021.
In the county of Worcestershire, assuming a 2.4% death rate, the 818 new cases this week could translate to about 20 Worcestershire deaths per week by the first week in March, but if cases are mostly confined to younger age groups it could be less.
Longer term forecast
It is impossible to provide a long term forecast this week due to uncertainty about government restrictions and the effectiveness of the vaccines in preventing transmission of COVID-19. The best we can do is speculate about what might happen.
Discussion in the media is now focused on the route out of lockdown and expectations for summer holidays. While daily cases fell steeply at first during the third lockdown, in recent days they have begun to approach a plateau of 10,000 new cases per day; so based on this week's figures a continued exponential fall to 1,000 new cases per day by mid April looks unlikely.
We think daily new cases could flat-line at roughly 10,000 new cases per day until the 8th March when children are expected to go back to school.
Before vaccination, 10,000 new cases per day would have led to 1,000 daily admissions to hospital, occupation of 10,000 hospital beds, later followed by 200 deaths per day. Vaccination of those aged 70+ could more than halve these numbers in coming weeks.
Because children are not vaccinated their return to school may push the Reproduction Rate above one causing the daily infection rate to rise in some parts of the country, as illustrated in the chart below, leading to a fourth wave of the epidemic. Hopefully rapid rollout of vaccine and tiered controls will keep this under control without the need for a fourth lockdown.
If for example daily new cases were to triple by the end of April, taking some account of vaccination, possibly up to 15,000 hospital beds might be occupied, followed by up to 300 deaths per day - a level the NHS could cope with; but should the government allow cases to spiral out of control hospitals could be placed under extreme pressure for a short while.
By mid April half the population should have been vaccinated. Now we have seen no official estimate of the basic reproduction rate of the Kent virus, but were it to be as high as 5, vaccination alone would only reduce the effective reproduction rate to 2.5 and so the wearing of masks and physical distancing would still be needed until the majority of the population was vaccinated (end July).
Forecast new daily cases to 20th April 2020
The chart above shows the falling number of daily new cases in red and an exponential curve which was last week's forecast in blue. Cases were falling faster than the exponential curve but have levelled off in recent days just as they did after the second lockdown. The green projection is an illustration of what might happen next. We have assumed cases stay level at 10,000 per day until schools go back on 8th March and then rise exponentially but at a rate half that of the third wave. So you will see towards the end of April new daily cases could either fall to 1,000 a day in the very best case, or rise towards 30,000.
Once most people, except children, have been vaccinated (now the end of July) it should be possible to relax the restrictions, but easing them while the daily number of new cases remains above 10,000 could lead to a fourth wave of sickness, more pressure on hospitals, and possibly up to 20,000 additional deaths of those aged below 60 years in the worst case, were COVID to spiral out of control. To avoid that the government is going to have to be extremely careful about how the restrictions are relaxed during the next 3 months.
The death toll will continue to mount until the vaccination programme eventually draws the UK COVID-19 epidemic to a close. We now expect the UK COVID death toll to reach 129,080 by the end of March 2021; see commentary.
Exactly what happens will depend on how carefully the government relaxes the restrictions, the effectiveness of test and trace, any change in the lethality of new variants of the virus, and most importantly the speed of the vaccine rollout.
Advice for Seniors
The
daily number of new cases of Coronavirus is still unacceptably high,
and we judge the risk MODERATE to
HIGH for Seniors living in the
Malvern Hills district who have not been inoculated; see our annex and riskometer opposite.
The risk could be approaching LOW for most Seniors who have been inoculated more than 3 weeks ago.
If you have not been inoculated and catch COVID there is a significant chance that you will either die or your long term health may be seriously damaged, so take care to protect yourself and those you love. 90% of COVID deaths are in those aged over 60 years according to NHS England statistics.
So if you are offered a jab grasp the opportunity with both hands.
The simple safeguards to remember are still to:
-
wash your HANDS thoroughly, using soap and hot water, for 20 seconds, including after handling deliveries to your home, to kill virus picked up from contaminated surfaces see note 1;
-
wear a FACE mask when unavoidably near other people for example when shopping, visiting hospital or the chemist;
-
SPACE at least 2 metres apart from others see note 2;
-
keep TIME near others as short as possible, see note 3;
-
self-isolate and book a test if you have COVID-19 symptoms (new continuous cough, fever or loss of, or change in, sense of smell or taste).
Hence the mantra:-
HANDS, FACE, SPACE, TIME - GET A TEST if you feel unwell.
Pulse Oximeter
A
doctor in Bournemouth speaking on the evening news suggested
that if you were sick with COVID at home it would be a good idea to have a
little device known as a Pulse Oximeter handy (see photo on right). This
measures the oxygen saturation in the blood and pulse rate by clipping the
device on a finger and pressing a button; the reading should normally be at
least 97%.
If the reading falls to about 93% you should call your doctor for advice, and if the reading is consistently below 92% you should consider calling an ambulance or visiting A&E.
Pulse Oximeters can be purchased from Amazon for £18 to £25; alternatively your doctor's surgery might loan you one if you are unwell and have tested COVID positive.
Remember, if you have symptoms of COVID-19 at home and can't count from one to ten out loud due to shortness of breath, you should immediately call your GP, 111 or 999 for advice.
Click for UK government Coronavirus guidance on what you can and cannot do
Notes:
1) Wash your hands thoroughly before touching your face to avoid transferring virus from contaminated surfaces to your mouth, eyes and nose. If outdoors use hand gel.
2) Two metres is further than you think - roughly an arm and a walking stick away.
3) During the National Lockdown you should not mix with other households.
Minimise exposure time if you unavoidably find yourself mixing in a confined setting - an invisible mist of virus can build up in the air if the space is shared with an infectious person; imagine people exhaling cigarette smoke. Unless you wear a well fitting FFP3 hospital grade face mask you can breath this in; a face covering will offer little protection. The likelihood and extent you get sick will depend on the density of the airborne virus, which can be reduced by ventilation, and the duration of your exposure.
Annex to 21st February update
Commentary
Again another week with not much to report.
On Tuesday there was a phone in about children returning to school. You would think by now scientists would have worked out how likely children are to pass on the virus but if they do know, no-one is saying.
A trial is starting of the vaccination of teenagers; obviously the government is thinking about vaccinating under eighteens in due course.
On Wednesday the Radio 5 debate was about no jab no job. In Israel a green pass system is being considered.
A COVID Challenge Trial was announced to observe the effect on the body of COVID infection in healthy adults in a controlled environment. Presumably money will encourage students to participate.
Police raided a lockdown party in Birmingham and found 150 people enjoying themselves in a makeshift 'nightclub'.
West Midlands police also raided a small social event where a dozen people had set up a pub named ‘The Covid Arms’ in a garage.
The Imperial College REACT survey covering 4th - 13th February reported a fall in the prevalence of COVID to 1 in 200. The highest infection was found amongst 18 - 24 year olds and 5 to 12 year olds.
Click to read abstract of REACT report
More recently the Zoe study reports the fall in daily cases has slowed and may be approaching a plateau.
On Sunday it was reported that the government had brought forward the date for vaccinating those aged 50+ to the 15th April, and those aged 18+ to the end of July.
Face masks
There has been a little debate about whether or not the public should wear more effective masks. This ranged from wearing either a simple face covering over a general purpose surgical mask or a N95 or FFP2 mask to obtain greater filtration.
The effectiveness of masks depends on having a good seal to the face so they work less well for people with beards or if badly fitted.
Dust masks come in valved and unvalved types. Valved masks only protect the wearer as air is expelled through a one wave valve and not filtered.
The British FFP2 disposable mask is equivalent to the US N95 mask and in the last year these have been difficult to come by. Availability is better now but price will probably put many people off using them to protect against COVID.
A washable multi layer cloth mask is likely to be more practical for the occasional visit to the shops.
Vaccines
Having vaccinated those aged 70+ the next target is to vaccinate those aged 50 - 69 by the 15th April. From mid March the vaccine will have to be diverted to giving second jabs to those aged 70+ years, so the government obviously think they will be able to double up on the vaccination rate.
The timetable for vaccination of those aged 18-49 has been brought forward to the end of July 2021.
An informative article about the rollout of the COVID vaccine can be found on the BBC website.
Here is a list of the vaccines ordered by the UK.
| COVID-19 vaccine | Doses ordered (million) | Status |
| Pfizer BioNTech, two dose, -70 deg C | 40 | Approved, delivery has started, made in Belgium |
| Astrazeneca, two dose, fridge | 100 | Approved, delivery has started after some delay, made in UK |
| Moderna, two dose, -20 deg C | 7+10 | Approved, should be available in the 'spring', supplied from either Switzerland or Spain |
| Valneva, two dose | 60+40 | A jab from French company Valneva will be made in Livingston, West Lothian, Scotland. Delivery to start in second half of 2021. |
| Janssen, single dose | 30 | A jab from Belgian firm Janssen, owned by Johnson and Johnson; phase III trials complete, should be available later this year |
| Novavax | 60 | A jab manufactured by US firm Novavax will be made in Stockton-on-Tees; phase III trials complete, could be available later this year. |
| GSK Sanoft | 60 | Some delay due to adjusting the formula to give better protection to the elderly; possible availability late 2021. |
| Curevac | 50 | Contract placed with German company Feb 2021. Possible source of new variant vaccine later in 2021 |
Table of vaccines ordered by the UK government
Recent deaths in Worcestershire hospitals
The table below shows all COVID deaths in Worcestershire hospitals reported by NHS England to 20th February.
| Worcestershire | Cumulative deaths | Weekly increase |
| Acute hospitals | 744 | +18 |
| Care hospitals | 57 | +2 |
| TOTAL | 801 | +20 |
In the last week 20 additional deaths have been recorded compared to 33 the week before.
Present rate of new cases
This week, the average rate of infection per 100,000 population per week in England fell from 167 to 128. In comparison the figure for Worcestershire is 141 and that in the Malvern Hills 111.
As a guide we would ideally expect the third lockdown to continue in the form of tiered controls in regions where the rate of infection remains above 10 cases per 100,000 per week. However it looks as though that might be very difficult to achieve in the UK.
For the time being Seniors awaiting vaccination should continue to be careful.
The probability of catching Coronavirus in the Malvern Hills is moderate, but combined with the significant risk of death makes us view the overall risk to Seniors, prior to inoculation, as MODERATE to HIGH.
The risk of death from Coronavirus for healthy teenagers is exceedingly small so for them the risk is LOW, whereas the middle aged can suffer from Long COVID so for them the risk might be assessed MODERATE.
Forecast of death rate during February and March
The average UK COVID daily death rate peaked at 1,200 deaths per day about 25th January and has begun to fall principally due to physical distancing. In coming weeks the vaccination programme should lead to an even faster fall in the death rate with deaths possibly tailing off to 100 deaths per day or less during March.
We predict the rolling 7 day average death rate will fall from 488 to 300 deaths per day by the end of February. Then assuming the death rate falls further to 100 deaths per day by the end of March as a result of the vaccination of over 60 year olds, the average could be 200 deaths per day in March leading to about 6,000 further deaths.
Adding these 'back of the envelope' numbers suggests the UK COVID-19 death toll could reach 129,080 by the end of March.
| Date | Forecast UK COVID-19 death toll (PHE basis) |
| February 21st | 120,580 |
| February 28th | +2,500 |
| March 31st | +6,000 |
| Total | 129,080 |
Forecast UK COVID-19 epidemic death toll by the end March 2021
Another projection of the future COVID-19 death toll and daily deaths can be found on The Institute for Health Metrics and Evaluation website:
Click for IHME projection of COVID-19 deaths
The latest projection is for 147,000 deaths by the end of March which probably won't be far off the figure reported by the ONS.
At the start of the epidemic in March the Chief Scientific Adviser, Sir Patrick Valance, suggested a death toll of 20,000 would be a good outcome; on the other hand, Professor Neil Ferguson of Imperial College warned in some scenarios the death toll might be as high as 250,000; while we thought, in the very worst case assuming up to 1% of the UK population died the outcome might have been nearer 400,000 taking into account some build up of herd immunity.
So how well will the UK have done? When Sir Patrick Valance spoke off the top of his head there had been few deaths and he clearly did not want to 'scare the horses'. Professor Neil Ferguson was nearest the mark. A few might consider an outcome of 129,000 deaths a fair result compared to a greater number of people dying in a very short space of time, more being permanently disabled by Long COVID, and temporary collapse of the NHS. Members of the Labour Party and others will no doubt say the UK has done very poorly compared to the best performing countries such as Australia, New Zealand and Singapore where deaths have been much lower, not to mention the enormous expense of supporting those out of work and huge damage to the economy.
Ultimately there can be no winners or losers, but there must eventually be a thorough inquiry to learn lessons for the future.
Summary of Links
Symptoms
Article about the effects of Coronavirus on the human body
Reporting and how to obtain a test
How to get a test
https://www.nhs.uk/coronavirus
About joining the Zoe COVID Symptom Study:
Guidance
UK government Coronavirus guidance
Tiers
Guidance on tiers: what you need to know
Government postcode checker to find tier for other areas
Statistics
UK government Coronavirus Dashboard
Coronavirus Dashboard Interactive Map
ONS data on deaths in England and Wales (Excel spreadsheet)
NHS England COVID-19 Daily Deaths
NHS England COVID-19 Hospital Admissions
NHS England vaccination statistics
Reports
ONS Coronavirus (COVID-19) Roundup
The bigger picture
Worldometer summary of coronavirus cases worldwide
European Centre for Disease Prevention and Control info
https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases
World Health Organisation info
Window on the USA
Centre for Disease Control (CDC)
American Association of Retired People (AARP)
Worcestershire
Help:
http://www.worcestershire.gov.uk/here2help
Worcestershire County Council COVID-19 information:
http://www.worcestershire.gov.uk/coronavirus
Here you will find a useful link,
'Website: Number of new cases by date in Worcestershire'
which displays interesting COVID charts and statistics for Worcestershire
Miscellaneous
Spanish Flu
Dr Jeff Kildea's commentary about the 1919 outbreak of Spanish Flu in Australia
Views of Martin McKee, Professor of European Public Health
Follow Martin McKee on Twitter
SAGE membership
Scientific Advisory Group for Emergencies (SAGE)
Scottish government:
Link to Scottish Government website
Link to Postcode checker for COVID restrictions by protection level in areas of Scotland
Welsh Government:
Guidance on COVID alert levels in Wales
The interpretations and opinions expressed are our own
Last updated 21st February 2021